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NPI Code Detail

MEDICARE: DREW WATKINS

MEDICARE: DREW WATKINS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1174163554
Entity Type Code : Individual
Provider Name (Legal Business Name) : DREW WATKINS
Provider Business Mailing Address
First Line : 1025 ATLANTIC AVE STE 101
Second Line :
City : ALAMEDA
State : CA
Zip : 94501-1188
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1005 ATLANTIC AVE
Second Line :
City : ALAMEDA
State : CA
Zip : 94501-1148
Country : US
Telephone Number : 415-474-7310
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2020
Last Update Date : 01/21/2026

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Directions to “ DREW WATKINS ” Practice Location

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